Which substance is commonly associated with hemolysis in dialysis?

Hemolysis during dialysis is primarily associated with the presence of chlorine or chloramine in the water supply used for dialysate. Chlorine can cause the destruction of red blood cells when it comes into contact with them, leading to hemolysis. This can result in free hemoglobin being released into the bloodstream, which can lead to further complications such as kidney damage or other systemic issues.

While fluoride, endotoxins, and pesticides may have their own adverse effects in certain contexts, they are not the primary substances linked to hemolysis during the dialysis process. Chlorine's strong oxidative properties make it particularly harmful in this regard, as it disrupts the integrity of the red blood cell membranes, causing them to burst and release their contents, which is a hallmark of hemolysis.